Bortezomib Against Refractory Antibody-Mediated Rejection After ABO-Incompatible Living-Donor Liver Transplantation: Dramatic Effect in Acute-Phase?
Journal
Transplantation direct
ISSN: 2373-8731
Titre abrégé: Transplant Direct
Pays: United States
ID NLM: 101651609
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
18
03
2019
received:
25
04
2019
accepted:
04
05
2019
entrez:
15
11
2019
pubmed:
15
11
2019
medline:
15
11
2019
Statut:
epublish
Résumé
Antibody-mediated rejection (AMR) is a refractory rejection after donor-specific antibody-positive or ABO blood-type incompatible (ABOi) organ transplantation. Rituximab dramatically improved the outcome of ABOi living-donor liver transplantation (LDLT); however, an effective treatment for posttransplant AMR, once occurred, is yet to be established. A 44-year-old woman with biliary cirrhosis underwent ABOi-LDLT from her sister (AB-to-A). Pretransplant rituximab diminished CD19/20-positive B lymphocytes to 0.6%/0.0%; however, AMR occurred on posttransplant day-6 with marked increase in both CD19/20 cells (17.1%/5.8%) and anti-B IgM/G-titers (1024/512). Despite rituximab readministration, steroid-pulse, intravenous immunoglobulin, and plasmapheresis, AMR was uncontrollable, with further increasing CD19/20 cells (23.0%/0.0%) and antibody-titers (2048/512). Bortezomib (1.0 mg/m
Identifiants
pubmed: 31723586
doi: 10.1097/TXD.0000000000000932
pmc: PMC6791599
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e491Informations de copyright
Copyright © 2019 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.
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